How to Handle Online Business Reviews–Good, Bad, or Ugly

Part of managing a practice is knowing how to respond to feedback. It may be especially difficult to know how to respond to negative feedback delivered online.

Cultivating an online presence for your business has predictable pros and cons. Expanding any type of marketing can lead to dramatic improvements in the way your practice gets found and the number of potential clients who contact you. But an online presence can also result in more feedback than you’re used to–both positive and negative.

Sure, Miss Manners might advise visiting a business and offering complaints in person before jumping on the internet to register offense, but it’s increasingly clear her wise words often fall by the wayside. Though some may say there’s no such thing as bad publicity, it’s important to know how to interact with your online audience to best serve your practice.

Why Respond at All?

Think about the last time you were researching a business online–a restaurant, for example. You might visit their website to check out the menu ahead of time or see their hours of operation, but you likely also want to know what other people are saying about the service, the food, the cost value, and more. You might have checked Facebook, Yelp, Angie’s List, or Better Business Bureau for reviews.

Whether you’re aware of it or not, you are not forming an overall impression of the business only by reading what previous patrons have to say; you are also looking for a professional response to these comments. If an employee of the establishment responded extremely defensively, blamed the patron in some way, or was otherwise rude in return, that would likely influence what you thought of the business.

Similarly, your opinion may be swayed if the company did not address any of the concerns logged by customers. You might wonder whether those issues have been addressed or whether the company cared at all about working to fix the problems mentioned. A simple acknowledgement of any comment demonstrates the business owner’s commitment to customer satisfaction. Even if the individual commenter never visits the establishment again, the interaction reflects positively on the business in the eyes of future visitors doing research.

Responding to Positive Comments

Taking compliments and kudos is the easy part of managing your online presence. Don’t fall into the trap of thinking kind words can simply be left alone; even a glowing review deserves a thoughtful response. People don’t often take to the internet to say something nice, so take the time to address individuals who verbally appreciate your services. “Thank you!” goes a long way on its own, but here are more ways you can acknowledge their gesture:

  • I’m honored by your kind words. Thank you!
  • It was a pleasure to meet you! I hope to see you again soon.
  • Please let me know if I can do any more to aid your healing.
  • I’m so glad to hear you’re feeling better!

Addressing Negative Feedback

Receiving criticism can feel like a punch to the stomach–especially because the internet offers a special kind of anonymity people often feel comfortable using with abandon. The occasional bodywork session might go poorly, for whatever reason. Or, you may do everything right and feel a special rapport with a client, but that person still fixates on the one aspect of their experience beyond your control. Reclaim the interaction by recognizing the person’s opinion and graciously replying in the most appropriate way you can.

If something is particularly hurtful or damaging, or if it may endanger your practice altogether, some platforms do allow you to delete comments. However, remember word-of-mouth is powerful, and someone may feel emboldened enough by your attempts to eliminate the feedback to criticize further. In fact, it can reflect positively on your business if you’re willing to let negative reviews sit with your courteous responses to them.

When you first see a highly critical comment about you or your practice, take a deep breath. An emotionally charged response may be tinted with anger and less likely to reflect your true compassion and understanding. Put yourself in the commenter’s shoes and try your best to adopt their perspective. Rather than making excuses or going overboard to explain a backstory for the person’s complaints, make constructive suggestions and offer an apology, if appropriate. Thank them for offering their viewpoints, and focus on moving past the offense.

Some responses that may work:

  • I would love to speak with you personally about this experience. Please get in touch with me when it’s convenient for you.
  • The issues you mention are things I am actively working toward resolving. I appreciate your patience as this process happens.
  • I would never want a client to have the experience you mention. I hope you will let me remedy this situation and offer a better service in the future!

The way you respond to any commenter, critical or otherwise, can make more of an impact than the original post on visitors and potential clients who are researching your practice. Invest a bit of time in addressing any comments you receive, and your online presence will be better for it.


  • Martin, J. (2010). Complain in person before jumping online. The Washington Post. Retrieved from

Why You Should List Your Massage Practice in an Online Directory

Listing your practice in an online directory like Massagetique can benefit you in many ways. It’s also likely to be simpler than developing your own website.

Like it or loathe it, the internet has brought communities closer together, made organizations far and wide more accessible, and brought information-sharing abilities to a new level. All of these can mean positive growth for your business, if you know how to use your online presence to your advantage. New to the world of online marketing altogether? Check out Massagetique’s free marketing guide for massage therapists to get started.

Part of your online marketing presence will probably be a website, another a Facebook page, another perhaps a listing with a generic directory such as Yellow Pages. In addition to your personal website and social media presence, it is in your best interests to strongly consider joining an online directory that specifically lists massage therapists and bodywork professionals. Directories like Massagetique can help you reach more people and grow your clientele, but they also provide vital business support in ways that aid all aspects of your practice.

More Visibility

Google processes billions of internet searches per day. In fact, approximately 40,000 searches are done every second. Furthermore, over a third of people look for businesses and retailers online. With so many people looking for information constantly and so much competition for ranking search results, how can you ensure your practice is found?

Online directories are a way of boosting your chances of being seen online. Search engines like Google prioritize sites with reliable content, high visitor counts, and a more established web presence. Directories, which tend to publish articles regularly and may be run by companies with the ability to invest in farther-reaching advertising efforts, have a distinct advantage in search engine ranking systems.

This means someone searching for “massage in Los Angeles, CA” is more likely to see a link to a directory than a link to your personal website. Plus, a ZIP code search through a directory like Massagetique will better direct potential clients to you if your office is located in a suburb or outside city limits.

Less Maintenance Than a Personal Website

Chances are, you probably don’t have an academic or professional background in web development or design. Though most websites make it easy for even those with no background in website management to set up and maintain a personal business site, it can still be tricky (and time-consuming) to establish an online presence with your own website. Marketing experts advise updating your site’s content often, engaging with visitors in a timely manner, and handling anything that goes technically awry. Even if you had the know-how to accomplish all these things on a regular basis, finding the time is another matter.

Listing in an online directory means being able to set up an inviting profile and leave it untouched for months and still see positive results. As you manage the day-to-day tasks associated with running your own business, a directory continues to improve its standing in search results, grow a social media presence, and help drive potential clients to your profile.

Cost-Effective Business Growth

Return on investment (ROI) is an understandable priority for business owners. You want to know the time and money you’re putting into a marketing strategy will yield the results you want in terms of client growth and retention. When it comes to finances, there is almost no reason not to list with a directory. Basic membership with Massagetique, for example, is free, so your only investment is the minimal amount of time it will take you to create a thoughtful, inviting profile.

In weighing directory options that cost money, consider how much you will make back if even one person begins to see you once a month for bodywork. A $30 per month membership fee, then, is worth it if one paying client pays twice that for a monthly massage session. And because word-of-mouth marketing is so effective for business owners, one paying client can easily lead to more.

One-Stop Resource for Your Clients

Many directories, including Massagetique, are constantly publishing news, information, and timeless resources that help people who are new to bodywork learn about different modalities and feel comfortable about the experience of receiving massage treatments. The more extensive these resources, the better chance potential clients will stumble across the content featured through a directory’s website and be moved to seek massage for themselves.

Articles highlighting the importance of massage for elders, for example, or detailing the benefits of bodywork for those with Alzheimer’s or depression, are all helping reach specific audiences that may not have considered massage therapy before. These resources are also an excellent way for you to connect with current clients by recommending reading and materials for self-care at home.

Even apart from the technical support, marketing wisdom, and visibility a directory offers, it’s worth trying a membership on a directory simply for the peace of mind that comes with knowing the bulk of your business marketing efforts are being handled. Learn how you can set up your listing today to start reaching more potential clients than ever.


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How to Keep Good Habits as a Massage Practitioner

Developing good habits may not be something you often take time to consider, but maintaining a routine can help you achieve greater success–and well-being

There are numerous elements to your life and career as a massage therapist, and surprisingly few of them have to do with giving a bodywork treatment. You’re likely juggling all the elements of running a business—paying bills, organizing client files, ordering supplies, and keeping a clean office—not to mention marketing your practice to receive more client referrals. You’re likely also trying to take care of yourself and maintain some work-life balance so you continue to enjoy the work you do.

Developing good habits in your practice can help you stay accountable not only to your clients, but also to yourself. There’s no need to make dramatic changes, since habits are no more than repeated behaviors. Start by doing an activity just once and continue for a few days. Before you know it, your consistency will turn into habit. What works for others may not work for you, so take care to tailor your approach to your own lifestyle and abilities.

Learn About Yourself

Are you a person who thrives on getting up with the sun? Waking at the last possible minute and drinking no less than three cups of coffee? Maybe things have been so erratic you’re not even sure whether you’re a night owl or early bird.

Some people find it helpful to use a personality test or lifestyle philosophy to learn more about how to live their best lives. Examples include the Myers-Briggs personality types, Chinese medicine, Ayurveda, astrology, the Human Design system, and more. If it’s valuable to begin developing habits based on what you find to be your type or classification within one of these systems, numerous internet resources can help you determine where you fit in the philosophy and provide tips for living your best life accordingly.

If you’d rather forge your own path, try simply paying attention to what makes you feel good. If your mind is sharper in the mid-afternoon, save your billing, paperwork, or personal study until later in the day when you have finished your appointments. Avoid scheduling clients just after noon if, like many people, you tend to “crash” after lunch. Instead, try recharging before you greet your next client with a 20-minute nap.

Tuning in to what your body and mind crave in terms of rest, exertion, stimulation, and relaxation will help you prioritize self-care, an essential part of any routine.

Set Your Intentions

Writing can be a powerful tool for enforcing what we know and holding ourselves accountable. Research supports the practice of self-reflection through journaling every day, and some of the personality philosophies listed above recommend it as a daily activity. But unless you would like to make a habit of it, there’s no need to commit to long entries every day.

Start with a few very simple lists: things you would like to incorporate into a morning routine, habits you’d like in an evening routine, and a few practices you’d like to accomplish throughout the day. Some examples might include:

  • File intake forms for each client right after their appointment.
  • Update office inventory list at the end of every day.
  • 15-minute power nap after lunch
  • Walk outside for 30 minutes before work.
  • Do one thing each day to market my practice/reach more clients.

You might also include some notes about what you notice is working for you as you pay more attention to your existing habits or the things you want to change. Even if you just do this once, it can be extremely valuable to revisit your findings later and measure progress.

Tailor Your Practice to Your Habits

Creating good habits might be all about experimentation at first, unless you have previously done the work to learn what habits best serve you and your practice. When something doesn’t work, modify it. For instance, if you find it’s impossible to nap for 15 minutes after lunch, try a seated meditation for five minutes instead.

To the best of your ability, build your schedule and practice around your habits as much as you build your habits around your practice. The monetary bottom line of your business may take precedence on paper, but meeting your own needs ultimately determines how you are serving your clients, working efficiently, and maintaining your own health and wellness.

Stay Flexible

One day is rarely like the next when you run your own practice, and often you may need to compromise some consistency to be productive, keep appointments, or stay available to clients. Try not to feel like you failed if you experience a day—or week—of broken habits. When you know what works for you and what habits help you be successful, it will be easier to revert to good habits.

The body thrives on consistency. As any massage therapist knows, every system within the body has its own routine—the jobs it carries out when it’s functioning properly. Your digestion, sleep cycle, and circulation are more likely to work predictably and efficiently when supported by good habits.


  1. Blake, T. K. (2005). Journaling; An active learning technique. International Journal of Nursing Education Scholarship, 2(1). Retrieved from
  2. Borys, A. (2013). A daily routine keeps the body, mind and soul healthy. Fern Life Center. Retrieved from
  3. Haines, A. (2017). Sticking to good habits in your massage business. Massage Business Blueprint. Retrieved from
  4. Newlands, M. (2016). 5 reasons to keep a consistent schedule. Huffington Post. Retrieved from

How To Find the Right Massage Therapist for You

Even a qualified, skilled massage therapist may not be the best fit for you. Learn more about finding the right bodywork professional for your unique needs!

For years you’ve heard about the benefits of massage. A coworker recommended it when you strained your back; your brother is always talking about the relaxing bath he takes before his massage; your friend even said it helped her process grief after her father died. So, now what? How do you go about experiencing this magic for yourself?

Bodywork, in addition to being a mode of healing, stress relief, injury rehabilitation, and more, is a method of communication. Just as not everyone communicates in the same way, each massage therapist delivers a different experience. Finding a person whose skills, manner, and approach are compatible with your needs and preferences may take time, but the end result will be greater comfort and relaxation.

Do Your Research

First, examine your reasons for seeking bodywork. Are you an active athlete looking for steady treatments to optimize your performance? Are you recovering from an injury? Have you been experiencing severe stress or discomfort? Or would you just like to escape from the world for a bit and restore some balance to your energy?

There are dozens, if not hundreds of types of bodywork, ranging from traditional deep tissue massage to light Healing Touch therapy, as well as movement therapies and energy work therapies. Each type can address different concerns, and you may find that two modalities complement one another for greater wellness. Understanding what you’re hoping to address through massage will help you narrow down which type(s) of treatments are right for you and select a professional who practices this type of treatment.

If you’re not sure what treatment will be best, that’s OK, too. Schedule an appointment with a massage therapist and experience the treatment, then share your health history to determine whether there are alternative therapies you could consider.

Choose a Massage Therapist

It’s extremely important to find a bodywork professional who is knowledgeable, skilled, and properly credentialed for the work they do. No matter where you search, make sure the therapist you choose has received the proper certification.

Personal referrals are a good place to start. If someone you know has been talking to you about their wonderful massage therapist, they likely can vouch for the therapist’s credentials. Even though what works for someone else might not work for you, a glowing review is hardly a bad sign. In very populated areas, a good recommendation can help narrow the field when it seems like there are too many options.

What if you don’t know anyone who uses a massage therapist in your area? Rather than searching online and combing through pages and pages of results, consider using a trusted online directory. Massagetique and other similar directories list professionals whose background and credentials have already been verified and approved, and you can usually narrow your search to a specific modality if you have one in mind.

Collaborate with Your Massage Therapist

Finding the right massage therapist doesn’t end with picking up the phone and making an appointment. Before the communication of bodywork can happen, there needs to be thorough communication between the client (you) and the therapist. Intake paperwork before the session can cover current or pre-existing health issues and concerns you might have, but you also have a responsibility to talk with your massage therapist about any additional considerations.

Do you have allergies to any oils? Are your feet extraordinarily ticklish? Would you prefer a silent treatment room, classical music, or ocean sounds? There are many topics you might want to discuss with the practitioner before starting your session so you can both have an optimal experience. A good massage therapist will ask these questions and more to understand what brings you in for treatment. They will also talk with you a bit about what to expect from the session, especially if you are relatively new to bodywork in general.

Continue to communicate during the treatment if something is uncomfortable or unexpected. A practitioner can learn a lot through contact with your body—whether a muscle is particularly tight, for example—but not your personal tolerance for pressure and movement. Be transparent about your comfort level. Neither you nor your therapist benefits from a white lie about how you’re enjoying the treatment.

Be Willing to Try Something Else

Even a great massage from a great massage therapist may not be the right fit, and it’s OK to recognize that and continue to look for the treatment that best suits you. Whether you find you need a different kind of physical pressure or you are more interested in bodywork that helps restore energy flow and promote emotional wellness, it’s important to continue searching for the right modality and practitioner for you.

Don’t be afraid to ask the first massage therapist you visited for recommendations, as well. A good massage therapist will respect your desire to keep exploring bodywork with different practitioners. Your health journey is very personal, and you deserve you find the right person to help you feel your best.

Finding Work-Life Balance While Running a Massage Practice

In 2010, Investopedia ranked massage therapy as one of the top five high-paying, low-stress jobs available. Whether you agree or not, any job can have its ups and downs, and any professional is bound to need some reminders about caring for the self under pressure and maintaining a balance between their career and home life. A job like massage can be both physically and psychologically stressful, so keep these tips handy to help ensure well-being and the best experience for your clients.

Set hours that maximize your efficiency and abilities.

If you know you are sharper with paperwork and billing matters in the morning, for example, try not to schedule clients before 10 a.m. If you find you can put more physical energy into a massage in the afternoon, reserve those appointments for more vigorous treatments when possible.

Build in time to recharge between clients.

Rushing from one appointment to the next creates stress for you and does a disservice to your clients, who are anticipating a calm, relaxed atmosphere for their bodywork session. In addition to building a cushion for things like changing sheets, cleansing your workspace, and switching the music, create time and space for yourself to meditate, call your family, or do whatever helps you recharge.


When your hands are occupied (and covered in oil or lotion) for at least 60 minutes at a time, you’re not necessarily thinking about reaching for your water bottle. But massage, even when performed well, is physically taxing on the therapist. Be sure you’re drinking enough water between sessions to balance the exertion of your practice.

Trade with a colleague.

Massage therapists may tend to neglect self-care even while promoting it to clients and studying health and wellness. If you are someone who says, “You always have time for a massage!” take your own advice and make time to get a massage. You might even swap bodywork treatments with a colleague—maybe you offer hot rock massage and know someone who gives an excellent exfoliation treatment. You can both ease some stress by taking a few hours to experience one another’s specialty.

Don’t sell yourself short.

Your time is valuable! You have worked hard to be able to offer the services you do. Though you might find some people who think bodywork is frivolous or nonessential or believe massage is something “anyone could do,” your education and experience say otherwise. Select rates that are in accordance with the industry standard in your area, and no less. This will also help ensure you’re not overworking yourself to make ends meet.

Don’t fall in a rut.

If you’re doing the same type of practice day after day, year after year, you might experience burnout more quickly. With a massage license and a world of continuing education at your fingertips, you can shake things up fairly easily by learning new skills and disciplines. If you’ve been practicing shiatsu massage for a few years and it’s starting to feel like a grind, learn a new practice like cupping, reiki, or lomi lomi. You might also choose to vary your surroundings by offering house calls or visiting nursing homes. Altering the space you consider your office can make your practice feel new and help you feel re-energized.

Take a break.

Any job, even one you love, can feel draining when it gets too monotonous. So step away from scheduling for a week (or even a long weekend here and there) and take a much-needed vacation. Go camping for a night, visit a beach with family, or just relax at home—as long as your home isn’t also your office.

Care for your mental health.

Massage is considered a health care profession. As caregivers, massage practitioners are subject to compassion fatigue, or caregiver burnout. Spending hours a day meeting others’ wellness needs may mean yours are not being addressed. Pay attention to the times you may be feeling down, anxious, lethargic, or hopeless. If you experience depression or any symptoms of caregiver fatigue, consider making an appointment with a mental health professional to address mental wellness.

Walk the walk.

If you’re advising clients (within the bounds of your credentials) about nutrition choices, fitness, stretching, or self-massage, take your own advice when it applies to you. Lead by example and put your knowledge of health and wellness to work for yourself.

Stay positive.

Though it may seem trite, a good attitude can go a long way toward maintaining your positive image with clients and ensuring your personal momentum throughout the workday. Adopt a vision of success, serenity, and wellness, and chances are you will pass that along to your clients.


  1. Beck, M. F. (2011). Theory & practice of therapeutic massage (5th ed.). Clifton Park, NY: Milady.
  2. Bell, A. (2010). 5 high-paying, low-stress jobs. Investopedia. Retrieved from

Ways to Celebrate EveryBody Deserves a Massage Week

At Massagetique, we believe in the importance of sharing the benefits of massage with the community. EveryBody Deserves a Massage week encourages massage therapists and bodyworkers across the country to come together and do just that. This recognition week was founded by Associated Bodywork & Massage Professionals (ABMP) in 1995 to help promote the importance of massage and bodywork within local communities.

Join the Massagetique team and others in recognizing EveryBody Deserves a Massage Week from July 16-22. We encourage you to share the benefits of massage with those around you during this week and take steps to make massage more accessible to everyone in your community.

You might do this by:

  • Teaching a class on massage
  • Giving a lecture about different types of massage
  • Hosting an event to demonstrate massage techniques that can be practiced at home as self-care
  • Volunteering your services or offering discounts
  • Creating a contest
  • Creating and sharing informational flyers. 

The Massagetique team has created images you can share on social media and elsewhere to help promote EveryBody Deserves a Massage Week. Feel free to save, download, and/or print the images below and use them in your marketing materials (click on an image to download the file).

Additionally, here are educational articles about massage you can share on your blog, social media platforms, or other outlets throughout the week:

Throughout the week, Massagetique will share massage resources on our website and social media platforms and highlight ways massage can promote wellness and help treat health conditions. Let us know how you intend to celebrate EveryBody Deserves a Massage Week in the comments below. Share with us on Facebook, Twitter, or Instagram using the hashtag #EveryBodyDeservesMassage.

Customer Service Matters: Strategies that Make a Difference

Massage clients may remember more about your office and interactions than the massage itself. Learn how to optimize the experience for their (and your) benefit.

Do you remember the first time you got a massage? What stood out most to you? Chances are you remember more about the interpersonal experience than the massage itself. The atmosphere of an office, as well as the practitioner’s disposition, can make or break the aspect of relaxation for someone, and it’s essential massage therapists know how to properly welcome someone to their space–whether it’s their first time receiving massage or not.

Clients may have any number of takeaways from the experience of visiting you for massage, and these may or may not have to do with your bodywork technique. One person may remember how difficult it was to park, while another might be distracted by your shoes when they’re staring through the face cradle. Of course, as a practitioner you have more control over some things than others, but doing everything in your power to optimize elements you can control will still make a difference.

1. Stick to Basic Codes and Regulations

Visitors learn a great deal about you and your practice simply from how you personalize your environment. First and foremost, your office should facilitate sanitation and client safety.

In addition to following basic requirements of a business owner, such as adhering to fire safety codes and ADA guidelines, reduce clutter and aim for flow of movement throughout the office. Clean supplies and equipment regularly, and check for proper function and safety. In your practice, adhere to all conduct codes and licensure requirements

2. Create Warmth in Your Workspace

While ensuring proper hygiene practices and sanitizing surfaces and linens after each use, avoid creating a space that feels sterile. Stiff chairs and stark white walls can make clients uncomfortable, so add a relaxing color scheme and plush cushions that promote relaxation. When possible, use soft, natural light and dimmer switches on any lights in the treatment room. Promote air flow through the office with proper ventilation and a comfortable temperature–about 72-75 degrees Fahrenheit.

If your space will allow it, designate a separate area for handling business transactions. Making payments and discussing money can make some people feel uneasy, so it’s best to remove these procedures from the bodywork space.

3. Make a Personal Connection

A massage therapist with excellent customer service skills will not just make an impression on their clients–they will also allow their clients to make an impression on them. Learn a client’s health history and the concerns that brought them in, but also pay attention to the client’s stories. Being able to greet someone by name and remember something about their life goes a long way in forging a solid therapeutic relationship.

4. Offer Options for Personalizing the Experience

Some people may love the lavender mist you spritz around your treatment room and the peppermint lotion you use on their feet. Others won’t be as keen on it. In addition to learning any allergies or skin sensitivities to products you use, let people know your go-to items and give them some selections. Have clients choose the music that plays during their treatment or the oils they want in a bath, for example.

Though to many clients such elements will hardly be the focal point of the massage, most will appreciate this consideration and be glad for the opportunity to state their preferences.

5. Cater Your Method of Service

It should go without saying, but always use a client’s health history and any current health conditions to inform your work. Focus on the client’s areas of concern at their personal comfort level, and stay present throughout the session to actively measure how the treatment is being received. There is no “autopilot” mode in bodywork. Giving your full attention conveys you take your work seriously and that your clients’ needs are your priority.

6. Support Aftercare Following Treatment

For regular clients who are otherwise healthy, aftercare may simply mean providing tea or water and light conversation after a service. Simple, small gestures like these can help prolong the relaxing effects of a bodywork session. Clients experiencing acute or ongoing physical health issues may benefit from more support, such as at-home treatment recommendations. You might suggest an ice pack for someone’s shoulder, for example, or some light stretches for another person’s hip. Again, this attention to personalizing the experience for each client earns you trust and authority in your work.

Bodywork is about so much more than an exchange of services and payment, and the therapeutic relationship should support the healing benefits of treatments. Making someone feel comfortable doesn’t just help ensure they will return for more appointments; it also enhances the healing effects of bodywork services. Clients who are unable to relax will likely find it difficult to glean any benefit from the session. It’s in your best interests, as well as your clients’, to make the experience as enjoyable as possible.


  1. Beck, M. F. (2011). Theory & practice of therapeutic massage (5th ed.), 291-295. Clifton Park, NY: Milady.
  2. Bove, L. L., & Johnson, L. W. (2000). A customer-service worker relationship model. International Journal of Service Industry Management, 11(5), 491-511. Retrieved from

Massage Therapy for Lower Back Pain Now Recommended Before Drugs

On February 14, 2017, the American College of Physicians (ACP) released a clinical practice guideline recommending physicians prescribe massage therapy and other non-opioid interventions for back pain before opioid drugs. This recommendation represents a significant shift in the United States medical community’s guidelines toward massage therapy and pharmaceuticals.

According to the Penn State Department of Orthopaedic Surgery, more than 80% of people will feel lower back pain at some point in their lives. Physicians often find it difficult to identify the causes of this condition, which may include a vast array of injuries and diseases such as:

  • Muscle strain
  • Ligament damage
  • Ruptured or bulging discs
  • Arthritis
  • Scoliosis
  • Osteoporosis

Because of the difficulty of identifying and treating the root cause of lower back pain, painkillers are a common treatment for managing the pain. However, the most effective painkillers—called opioids—carry major risks, including overdose and addiction. According to the Centers for Disease Control and Prevention, sales of prescription opioid drugs quadrupled from 1999 to 2014, and nearly 20% of people treated for non-cancer related pain are prescribed opioids.

What Are Opioids?

Opioids exist naturally in your body as endorphins and transmit messages between your nerve cells (and in your digestive system). Opioid pain medications bind to cells’ opiate receptors, blocking pain signals headed to the brain. In strong concentrations, these chemicals can cause euphoria, confusion, sleepiness, nausea, constipation, and respiratory problems.

Because opioids affect the brain areas involving pain, pleasure, and reward, people may become addicted to the drugs, especially after recreational use. Patients prescribed painkillers can also become addicted to these chemicals. They may continue taking opiates after the pain subsides, ingest more than the recommended dosages, and purchase these drugs illegally when their prescriptions run out. Some people addicted to prescription painkillers eventually switch from prescription opioid drugs to heroin or other opioids such as codeine or morphine.

New Treatment Guidelines from the American College of Physicians

To understand the new ACP treatment recommendations, you need to know the three terms doctors use to define lower back pain—not how bad it hurts, but how long it lasts:

  • Acute: Pain lasting less than 4 weeks
  • Subacute: Pain lasting 4-12 weeks
  • Chronic: Pain lasting more than 12 weeks

Duration plays a major role in treatment decisions, because many lower back pain episodes may go away on their own. In a few days or weeks, your body may heal itself, making further treatment unnecessary.

To curb the rising number of opioid prescriptions for lower back pain, the ACP offers three suggestions:

  1. Patients with acute and subacute lower back pain that may go away on its own should try massage therapy, acupuncture, heat, and spinal manipulation. People who prefer the pharmaceutical approach can try anti-inflammatory drugs and spinal muscle relaxants.
  2. Patients with chronic back pain should first seek out non-pharmaceutical activities like yoga and tai chi and mental interventions such as cognitive behavioral therapy.
  3. Patients with chronic back pain that does not improve after first trying non-pharmaceutical treatments should only consider using opioid pain medication after trying out non-steroidal or anti-inflammatory drugs and discussing the risks with their doctors.

Nitin S. Damle, MD, MS, MACP, former president and current board member of the American College of Physicians still cautions against opioid treatment.

“Physicians should consider opioids as a last option for treatment and only in patients with chronic low back pain who have failed other therapies,” Damle said. “[Opioids] are associated with substantial harms, including the risk of addiction or accidental overdose.”


  1. American College of Physicians. (2017, February). Summaries for patients: noninvasive treatments for acute, subacute, and chronic low back pain. Annals of internal medicine. doi:7326/P17-9032
  2. Centers for Disease Control and Prevention. (2016, December 20). Prescribing data. Retrieved from
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12 Characteristics of a Top Massage Therapy School

Today, aspiring massage therapists and bodywork professionals can choose from more than 300 accredited massage therapy schools in the United States. You could complete your study faster with an accelerated program or get a traditional four-year degree from a college or university. You could travel overseas to expand your massage therapy knowledge or stay right in your own backyard. You could study with professors, doctors, chiropractors, cosmetologists, or Chinese medicine practitioners.

With so many options and opportunities in this vibrant and growing field, how do you choose the right school for you?

Factors to Look For in a Massage Therapy School

When searching for a massage therapy school, it is important to consider the environment in which you would like to provide massage therapy services. Where do you want to work? Do you see yourself in a spa or a chiropractor’s office? At a resort or on a cruise ship? In your own private practice?

The type of school you choose will likely have an impact on the setting in which you practice. Here are 12 characteristics to think about when choosing the right massage therapy school for you:

1. Style – Spa Training Schools

Some massage therapists get their training and certifications from organizations that teach a variety of spa treatments. For example, the AVEDA Institute offers courses in massage therapy, cosmetology, and esthiology (skin care). You might select a spa training school if you see yourself providing massage therapy in a spa environment. Some schools even give you the option to simultaneously work toward licenses in both massage therapy and another spa treatment.

2. Focus – Massage-Only Schools

You may choose to gain your massage knowledge and experience at a school that focuses primarily on massage therapy. These programs may offer specific opportunities for students. For example, through the Cortiva Institute, Steiner Leisure Limited can provide assistance for placement at spa resorts and on cruise ships.

3. Perspective – Specialty Schools

Certain schools, such as the National University of Health Sciences, offer programs in alternative medicine, traditional medicine, and modern biomedical science. At these schools, you can share ideas with future doctors, naturopaths, chiropractors, and Chinese medicine practitioners while studying massage therapy. If you want a broader understanding of health and wellness, you might consider a school that includes allopathic and holistic approaches to healing.

4. Outreach – Health Care Schools

The New York College of Health Professions, the first college in the U.S. to offer a massage therapy degree in therapeutic bodywork, provides an innovative massage therapy program that focuses on a foundation of European massage but also includes curriculum on principles of Chinese medicine. Its students have the unique opportunity to spend a few weeks at the college’s medical facility in Luo Yang, China.

5. Tradition – College/University Medical Schools

Massage therapy students at traditional college and university medical programs, such as the Miami Dade College Medical Campus, benefit from the rigorous standards and sterling reputation of a world-class medical school. In addition to massage therapy instruction, these types of institutions may offer accelerated tracks for physical therapists and other health care professionals who want to add massage therapy certification to their existing credentials.

6. Dedication – Four-Year Degree Programs

Massage therapy schools typically provide technical certificate and associate degree programs, which can qualify students for further instruction. At Michigan’s Siena Heights University, students with associate degrees in massage therapy can pursue a Bachelor of Applied Science in Massage Therapy.

7. Credibility ­– State Certification Boards

Regardless of the school you choose, you will need to meet your state’s massage therapy licensing requirements. Ask school administrators how their programs of study meet (or exceed) state requirements. For example, the California Massage Therapy Council (the state’s regulatory body for massage therapy) requires 500 hours of study. Licensing requirements vary by state.

You will probably also need to take the Massage and Bodywork Licensing Examination (MBLEx) test, offered by the Federation of State Massage Therapy Boards (FSMTB).

8. Perseverance – Ongoing Education

To remain certified in your state, you may need to take continuing education classes. Florida, for example, requires massage therapists to study for 500 hours before gaining a license and earn an additional 24 hours every two years. Ask your massage therapy school what classes are offered to meet your state’s ongoing education requirements.

9. Achievement – National Certifications

The National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) offers massage therapy board certification and specialty certification. They require 750 hours of study and 250 hours of professional experience for board certification applicants. These standards exceed the requirements for most state entry-level licensing. the NCBTMB also requires a criminal background check, a current CPR certification, and a passing grade on the board certification exam.

If you want to gain recognition as more than just an entry-level massage therapist, ask your school if they are affiliated with a national certification board. Make sure they offer an expanded course of study that meets the higher standards of organizations such as the NCBTMB.

10. Accountability – Accreditation

The U.S. Department of Education recognizes the Commission on Massage Therapy Accreditation (COMTA) as the specialized accrediting agency for massage, bodywork, and esthetics. It’s this agency’s role to review curriculum and ensure massage therapy schools provide adequate and safe training to their students.

Some massage therapy schools gain voluntary accreditation through other accrediting agencies such as the National Accrediting Commission of Career Arts and Sciences (NACCAS), Accrediting Commission of Career Schools and Colleges (ACCSC), and the Accrediting Bureau of Health Education Schools (ABHES). These agencies offer assurance that a massage therapy program meets high standards, but they are more generalized accrediting bodies when it comes to massage therapy schools.

11. Community – School Visits

Though factors such as location, price, and duration will affect your choice of schools, you might want to also consider the types of students and professors with whom you want to engage. For example, if you love spas and have a passion for skin care, a traditional college/university setting might not be the best fit for you. Visit various campuses, meet massage school faculty and students, and sit in on classes before making your final decision.

12. Enjoyment – Explore Your Options

When you choose a massage school, find a place and a program you are likely to enjoy. Learn everything you can from your program while remaining flexible. Consider online classes and seminars to connect with and learn from experts outside your local area. Investigate travel opportunities, internships, and overseas programs to gain a perspective on the many styles of massage and the huge variety of people that make this healing practice their life’s work.


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